Balance Assessment & Treatment

When our body’s sense of balance is working correctly, we’re hardly are aware of it. But maintaining balance for even a simple act like walking across a room involves a continuous, complex set of often-subconscious calculations.

In fact, three different sensory systems work together to help us maintain equilibrium:

• Our eyes – or visual systems – provide information to the brain about our body’s orientation in relation to the walls, floors and other nearby objects.
• Our ears – or rather our vestibular systems, fluid-filled canals in our inner ears –send information to the brain about the position of the head in space as well as movement of the head. Think of them as something like a carpenter’s level.
• Specialized nerve cells in our muscles and joints – our body somatosensory systems – sense the position of our arms, legs and other body parts and adjust to conditions around us. When you take a step forward and feel increased pressure in the ball of your foot, that proprioreceptive signal is your somatosensory system in action.

The information from all of these systems is processed in the brain, which sends the body signals to act appropriately. If one or more of them is impaired, our ability to remain upright may be jeopardized.

Balance Assessment & Treatment Overview:

• Vestibular Rehabilitation/Balance Assessment & Treatment Program
• Balance & Dizziness Disorders
• Assessment & Treatment Process
• Assessment Phase
• Treatment Phase
• For More Information

Vestibular Rehabilitation/Balance Assessment & Treatment Program

When imbalance and dizziness occur, helping you overcome them is the mission of the Vestibular Rehabilitation/Balance Assessment & Treatment Program.

If you think you might benefit from a balance assessment, discuss the subject with your physician. A physician’s referral is required for admission to the program.

For more information about the program or to make a referral, please contact PRH Rehabilitation Services at 603-433-4015.

Balance & Dizziness Disorders

Our rehabilitation specialists have training and certification in the treatment of the following disorders:

• Vestibular (inner ear) disorders
• Benign Paroxysmal Positional Vertigo
• History of/or significant risk for falls
• Ongoing problems with balance/walking
• Persistent or progressive dizziness
• Dizziness caused by visual problems
• Minor head injury
• Dizziness originating after whiplash
• Peripheral Vertigo
• Vertigo following Acoustic Neuroma Resection
• Meniere’s Disease

Assessment and Treatment

Being seen in the Vestibular Rehabilitation program involves two parts – assessment and the treatment itself. A physician’s referral is required for admission to the program.

Assessment Phase

In the Assessment Phase, clinicians with specialized training in balance and vestibular disorder assessment and treatment provide the initial evaluation.

This evaluation includes:

• A detailed medical history designed to provide critical information regarding potential sources of the problem.
• Visual screening to assess visual tracking, gaze stabilization, acuity and visual fields.
• A musculoskeletal assessment to define posture, static and dynamic balance, gait analysis, range of motion, strength, sensation, vertebral artery screen and cervical screen.
• Positional and movement testing to assess the patient’s symptomatic response and potential areas of vestibular dysfunction.
• Computerized Dynamic Posturography (Static/Dynamic Balance Assessment and Sensory Organization Testing). This is a series of recorded balance tests designed to determine the patient’s limits of stability and degree of dynamic balance control and to analyze the interaction between vision, vestibular and somatosensory functions.

Treatment Phase

As a result of the evaluation, recommendations will be made for:

• Individualized vestibular rehabilitation to promote adaptation or habituation to a vestibular system dysfunction. Specific exercises and positioning techniques are performed to improve patient functioning to a level at which symptoms are experienced minimally or not at all. Goals of treatment may also include instruction in patient compensation strategies to effectively manage a more permanent vestibular loss.
• Balance rehabilitation/retraining, possibly including postural stability exercises, transfer training, vision retraining, programs which emphasize balance control in specific directions and at varying speeds, weight distribution training, flexibility and strengthening, agility drills and safety evaluation for home, work or sporting activities. Heavy reliance is placed upon an individualized home exercise program to assist in achieving patient goals in the most effective and efficient manner.
• Referral for ENT or neurological consultation, a comprehensive audiological exam and/or a detailed visual field analysis.

For More Information:

The Vestibular Disorders Association
http://www.vestibular.org/

National Institutes of Health National Institute on Deafness and Other Communications Disorders
www.nidcd.nih.gov